Tooth neck

introduction

In principle, every tooth in a human set of teeth has the same structure.
Regardless of whether it is an incisor, canine or molar, each tooth consists of a tooth crown that looks out of the gum and is visible, and a tooth root that anchors the tooth in the gum. The neck of the tooth lies between the crown and the root. In this area the tooth is narrower than at the crown and the root.

Tooth neck anatomy

As described in the introduction, the tooth neck is part of a tooth in addition to the tooth crown and the tooth root. The neck of the tooth is usually completely covered by gums (Gingiva) and anchored there. That is why the neck of the tooth is usually not or barely visible.
The gums form a natural gum pocket in the area of ​​the tooth neck, as it is deeply fused with the tooth root membrane. This pocket is usually about 2 mm deep. In contrast to the tooth crown, which is surrounded by a relatively thick layer of tooth enamel, the tooth neck is only surrounded by a very thin layer of dental cement, or not at all. The dentin below is exposed here or is only very slightly protected. The nerve fibers that carry information to and from the teeth run in small tubules in the dentin. This includes information about temperature, pressure and pain.

Read more on the topic: Tooth structure

Function of the tooth neck

The tooth neck describes the transition from the tooth crown to the tooth root. The enamel of the crown runs out at the tooth neck towards the root cement. In healthy conditions, the neck of the tooth is tightly enclosed by a cuff formed by the gums. The neck of the tooth is no longer covered by a protective layer of enamel. This means that in the area of ​​the tooth neck, the dentin normally lying under the enamel in the area of ​​the tooth crown is exposed.

The dentin is interspersed with many small canals that lead to the tooth pulp. For this reason, the dentin is very sensitive to chemical, thermal or mechanical stimuli. Under normal circumstances, a gum cuff encircles the neck of the tooth and protects the dentin from external stimuli. In the case of receding gums in the area of ​​the tooth neck, which can arise due to various causes, the dentin is particularly sensitive and prone to the development of caries.

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Tooth neck discomfort

Pain in the neck of the tooth

Since the neck of the tooth is not surrounded and protected by hard enamel, but only by a thin protective layer of dental cement, the dentin is almost or even completely exposed here. The dentin contains all the nerve fibers that perceive pain stimuli in addition to temperature and pressure sensations. In the area of ​​the tooth neck, every tooth is therefore very sensitive to pain stimuli.

Normally, no pain stimuli reach the neck of the tooth, as it lies in the gums and is protected by them. For various reasons, however, the neck of the tooth can be accessible to external stimuli, for example when the gums recede, and cause pain.

Read more on the topic:

• Receding gums
• Toothache

Exposed tooth neck

A common reason why toothache develops is an exposed tooth neck. This is the case when the gums retract and reveal the sensitive neck of the tooth. Often the so-called marginal periodontal disease the cause of the retraction of the gums. It is an inflammation of the gums caused by bacteria. The bacteria attack irritated gums and there is an increased tendency to bleed. This inflammation eventually causes the gums to retract.

However, excessive pressure when brushing your teeth can cause the gums to retract permanently and lead to exposed tooth necks.
If the neck of the tooth is exposed, it reacts very strongly to external stimuli such as warmth, cold and pressure. Since the nerves located in the dentin are not protected by tooth enamel on the neck of the tooth, it is extremely sensitive if the protection of the gums is lost. This is expressed in the fact that the patient feels pain with very cold or very hot food and drinks and may suddenly experience discomfort even if the teeth were not previously painful.

If the discomfort is very severe, the affected tooth neck can be sealed by a dentist. A fluoride varnish is used for this. This protects the sensitive nerve fibers and is no longer so sensitive to pain. In addition, the gums can be fixed over the tooth neck through an operation. Another possibility is the tooth neck filling, which not only protects against pain, but also treats smaller defects ("holes").

If the necks of the teeth are exposed, there is a risk of developing neck caries. It is therefore important to treat exposed tooth necks accordingly.

Read more on this topic:

• Exposed tooth necks
• Tooth neck is exposed - what to do?

Inflamed tooth neck

Periodontitis is often incorrectly referred to colloquially as tooth neck inflammation. This can lead to an inflammation of the tooth neck, as the gums recede and the tooth necks are exposed due to periodontitis, but it is not an inflammation of the tooth necks.

However, once the tooth necks are exposed and exposed to strong external stimuli, it can lead to inflammation. Exposed tooth necks are very prone to dental caries. There is an increased colonization of bacteria in the area of ​​the tooth neck and if they penetrate the inside of the tooth, the tooth or the tooth neck can become inflamed. This is extremely painful and manifests itself as a throbbing pain. A dentist should be consulted immediately.

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Cervical caries

Tooth decay can occur in different areas of the tooth. Tooth neck tooth decay preferably occurs when it is exposed due to various possible causes. Under normal circumstances, the gums surround the neck of the tooth like a kind of cuff. If the gums have receded, their protective function no longer applies. There is no protective layer of enamel on the tooth neck.

This means that the dentin is exposed and exposed to chemical, thermal or mechanical stimuli. Neck caries is usually symptom-free in the early stages. It is often expressed as whitish changes that are a sign of demineralization. As the stage progresses, those affected usually express excessive sensitivity to cold or heat. The defect caused by the carious lesion is also clinically visible here. Carious defects progress faster in the direction of the tooth pulp (= tooth pulp) due to the lack of enamel in the area of ​​the tooth neck.

Neck caries can also develop below the gums surrounding the neck of the tooth. This is usually discovered late because the gums hide the defect. As a rule, those affected do not visit a dentist until the tooth decay has infiltrated the pulp with the nerve endings running through it and the affected tooth has severe pain. In these cases, root canal treatment is usually unavoidable.

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Black discoloration on the tooth neck

A discolored tooth neck is only noticeable if it is exposed.
Normally the neck of the tooth is surrounded by the gums and thus protected from external stimuli. The tooth neck is not surrounded by tooth enamel and when it is exposed it is extremely susceptible to all stimuli. These include, above all, food and drinks that can only come into contact with exposed tooth necks. There are many ingredients in food and drink that can discolour teeth.

This includes nicotine, coffee and black tea in particular. Teeth all change color over the course of life. Since this is a creeping process, this is usually not noticed. Since the tooth necks do not have tooth enamel as a protective layer, they are also more prone to discoloration and this shows up more clearly and quickly. Eating certain foods can cause the necks of the teeth to turn brown or even black.

In the case of noticeably discolored tooth necks, it can also be tartar. This can be removed by the dentist.

Broken tooth neck

In most cases, a tooth breaks as a result of external force, such as a fall. If the entire tooth breaks off at the level of the tooth neck, this leads to massive pain, as many nerves run through the tooth neck. If possible, the broken tooth should be kept and preserved. You can put it in a glass of milk, for example. A dentist should be consulted immediately. This tries to expose part of the root and form a crown on it. He may still be able to use the broken tooth and, therefore, acting quickly is very important.

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Treatment options on the tooth neck

When do you need a tooth neck filling?

The earlier the tooth decay is recognized, the more gently the tooth structure can be removed. The dentist carefully checks with a blunt probe whether the dentin of the tooth neck is already softened. This is a sign of the need for a neck filling. The procedure is similar to removing caries from the tooth crown. The caries is removed and then the resulting hole is filled with a filling.

The tooth neck filling serves, on the one hand, to replace the hard tooth substance lost through the removal of caries and, on the other hand, to provide future protection against chemical, thermal or mechanical stimuli. Nowadays, so-called composites corresponding to the tooth color are used as filling materials. These are special plastics that contain filling particles. They allow a long shelf life and an aesthetic result.

Read more on the topic: Tooth neck filling

How can you seal a tooth neck?

In many cases, it helps if those affected use a softer toothbrush or sensitive toothpaste. Due to its constituent aminofluoride, the dentinal canals that lead to the tooth pulp can be sealed or closed with a kind of cover layer. If the neck of the tooth has not been damaged by an inflammatory disease or is due to caries, the dentist can seal the neck of the tooth with the help of a special medical varnish.

In this way, the neck of the tooth is protected from thermal or chemical stimuli. Such a seal can in many cases lead to complete freedom from symptoms. The varnish used for sealing contains a large amount of fluoride in high doses. The varnish is applied to the exposed tooth neck. In this way, the dentinal tubules are also closed. Another way of sealing tooth necks is to apply thin-flowing plastic. First and foremost, a reduction in temperature sensitivity is achieved.

Read more on the topic: Fluoridation of teeth

What can you do about a sensitive tooth neck?

The treatment of a sensitive tooth neck depends on the cause of its development. If, for example, the underlying problem is caries, it is essential to visit a dentist for treatment. However, the cause can also be found in night-time or stress-related grinding of teeth. Due to the enormous transmission of force to the teeth and the teeth holding apparatus when grinding, the gums retract. As a result, sensitive tooth necks develop. In these cases, a so-called grinding splint is recommended, which absorbs the forces generated by the grinding.

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Furthermore, a sensitivity of the tooth necks can also be caused by an incorrect brushing technique or a toothbrush that is too hard. In this case it makes sense to seek advice from the treating dentist. In general, it is always advisable to apply a fluoride varnish or gel to the neck of the tooth in order to remineralise it and thus make it more resistant to irritation. It is also possible to have the neck of the tooth sealed in order to protect it from external stimuli in the future. To treat a sensitive tooth neck, it is generally very important to only brush the affected area very gently and, especially if there are several sensitive tooth necks, to find out the cause of their formation.

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